Optimization of Prosthetic Foot and Ankle Stiffness for Standing and Walking

站立和行走时假足和踝关节刚度的优化

• 批准号: 10261529
• 负责人: Steven A. Gard
• 金额: --
• 依托单位: JESSE BROWN VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-01 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10261529
• 关键词: Affect; Amputation; Amputees; Anatomy; Ankle; Articular Range of Motion; Biomechanics; Characteristics; Data; Development; Energy Metabolism; Equation; Equilibrium; Exertion; Gait; Individual; Intervention; Investigation; Joints; Kinetics; Knee; Leg; Limb Prosthesis; Lower Extremity; Manufacturer Name; Measures; Mechanics; Metabolic; Mission; Modeling; Motion; Normal Range; Patient Care; Patients; Perception; Performance; Persons; Phase; Prosthesis; Quality of life; Questionnaires; Radial; Recommendation; Reporting; Research Subjects; Risk; Series; Shapes; Speed; Testing; Validation; Veterans Health Administration; Walking; Water; ankle joint; ankle prosthesis; balance recovery; cost; experimental study; falls; foot; improved; joint stiffness; kinematics; novel; pressure; prospective; prosthesis wearer; prosthetic foot; public health relevance; research study; tool; walking speed

 DESCRIPTION: Persons who walk with lower-limb prostheses are generally less efficient ambulators than able-bodied individuals (Waters et al., 1976) and their stability is compromised, attributable in part t deficiencies in the function of their prostheses (Gard & Fatone, 2004). Anatomical ankle joint stiffness in able-bodied persons adapts with walking speed (Hansen et al., 2004) and for standing (Hansen & Wang, 2010). Fitting lower-limb amputees with prosthetic foot and ankle mechanisms that attempt to replicate corresponding anatomical functions is desirable (Hansen et al., 2004a,b, 2007, 2010). We previously demonstrated that prosthetic ankle joints improve walking performance in persons with transtibial (below-knee) amputation (Su et al., 2008, 2009, 2010). In that study, research subjects clearly preferred walking with the prosthetic ankle components, but several indicated that they felt unstable during standing (Su et al., 2010). Subsequent analyses of those data indicated that the addition of a compliant prosthetic ankle unit significantly reduced the radius of the ankle-foot roll-over shape (Gard et al., 2011), which can adversely affect standing stability and gait performance (Gard & Childress, 2001; Klodd et al., 2010a,b). The purpose of this investigation is to determine how systematically varying the prosthetic foot keel stiffness and prosthetic ankle joint stiffness affects standing and walking in persons with unilateral, transtibial amputations. The specific aims for this study are: 1. To determine how different combinations of prosthetic foot and ankle stiffness affect gait biomechanics of unilateral, transtibial prosthesis users. Kinematic, kinetic and energy expenditure data will be collected as subjects walk at different speeds and with different combinations of prosthetic foot and ankle stiffness. 2. To determine how different combinations of prosthetic foot and ankle stiffness affect standing stability of unilateral, transtibial prostheis users. Standing balance of subjects will be evaluated using a series of tests that measure balance and recovery stability as balance is perturbed. Subjects will also be administered questionnaires to document their perceptions of comfort, exertion and stability while using the different prosthetic foot-ankle configurations. Compliant foot-ankle mechanisms that allow for a normal range of ankle joint motion during walking are expected to increase gait performance, but decrease standing stability. Conversely, a rigid foot-ankle combination will likely maximize standing stability, but decrease gait performance. Determination of an optimal prosthetic foot and ankle stiffness combination will require a compromise between the apparent disparate objectives for these two activities. Increased understanding about how different prosthetic foot-ankle stiffness combinations affect standing and walking abilities will facilitate appropriate component selection by prosthetists, encourage development of prosthetic foot-ankle mechanisms with adaptable stiffness, and ultimately improve quality of life for prosthesis users.

 描述： 与健全的人相比，与下limb假体一起行走的人通常是效率低的救空者（Waters等，1976）及其稳定性受到损害，部分归因于其假体功能（Gard＆Fatone，2004）。健全的人的解剖踝关节刚度以步行速度适应（Hansen等，2004）和站立（Hansen＆Wang，2010）。希望将下limb截面物与试图复制相应解剖功能复制的假肢和踝关节机制拟合（Hansen等，2004a，b，2007，2010）。我们先前证明，假肢关节在截肢（膝盖以下）截肢的人中提高步行性能（Su等，2008，2009，2010）。在该研究中，研究对象显然更喜欢与假体踝部成分一起行走，但有些人表明他们在站立期间感到不稳定（Su等，2010）。随后对这些数据的分析表明，添加合规的脚踝单元显着降低了脚踝卷曲形状的半径（Gard等，2011），这可能会对站立稳定性和acuit性能产生不利影响（Gard＆Childress，2001; Klodd; Klodd et el。，Klodd等，2010a，b）。这项调查的目的是确定如何系统地改变假肢龙骨的刚度和假肢关节刚度会影响站立和行走 具有单方面，施加雄心勃勃的人。这项研究的具体目的是：1。确定假肢和脚踝刚度的不同组合如何影响单方面，三位一体假体使用者的步态生物力学。运动，动力学和能量消耗数据将随着受试者以不同的速度行走，并具有不同的假肢脚和脚踝刚度的组合。 2。为了确定假肢和脚踝刚度的不同组合如何影响单方面，trantibial Prostheis使用者的站立稳定性。将使用一系列测试来评估受试者的站立平衡，以衡量平衡和恢复稳定性，因为平衡受到干扰。在使用不同的假肢配置时，也将对受试者进行调查表，以记录其对舒适性，劳累和稳定性的看法。允许步行过程中允许正常踝关节运动范围的兼容脚轴机制有望提高运动性能，但会降低站立稳定性。相反，刚性的脚轴组合可能会最大程度地提高站立稳定性，但会降低运动表现。确定最佳的假肢和脚踝刚度组合将需要在这两个活动的明显不同目标之间妥协。对不同的假肢脚部刚度组合如何影响站立和步行能力如何有助于假肢主义者的适当组成部分，鼓励发展具有适应性僵硬的假肢脚部机制，并最终提高假肢使用者的生活质量，从而提高了假肢的僵硬组合。

项目成果

The Effect of Prosthetic Ankle Dorsiflexion Stiffness on Standing Balance and Gait Biomechanics in Individuals with Unilateral Transtibial Amputation.

• DOI: 10.1097/jpo.0000000000000451
• 发表时间: 2022-10-21
• 期刊: JOURNAL OF PROSTHETICS AND ORTHOTICS
• 影响因子: 0.6
• 作者: Vaca, Miguel;Stine, Rebecca;Hammond II, Paul;Cavanaugh, Michael;Major, Matthew J.;Gard, Steven A.
• 通讯作者: Gard, Steven A.